There are currently three agents approved for the frontline treatment of patients with Philadelphia chromosome-positive chronic myelogenous leukemia, making an upfront treatment decision difficult. To address this, panelist explore possible first-line options and nuances of selecting therapies.

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Jorge E. Cortes, MD, deputy chief and a professor of medicine in the Department of Leukemia at The University of Texas MD Anderson Cancer Center, discusses the frontline treatment options for patients with chronic myeloid leukemia (CML). This includes the most recent approval of a tyrosine kinase inhibitor (TKI), among 3 other FDA-approved TKIs.

The most recent change to the treatment landscape includes the FDA’s approval of bosutinib (Bosulif), a second-generation TKI. With this approval, there are now 4 FDA-approved TKIs available for the frontline treatment of patients with CML. Cortes says the bulk of the data for these agents show they all look consistent with imatinib (Gleevec) in terms of benefit. It is difficult to reconcile differences between these drugs as the studies are all similar, but Cortes says these are the standard of care.

Other important things that are emerging in this space include lower doses of agents such as dasatinib (Sprycel). Initial results for low-dose regimens of nilotinib (Tasigna) and bosutinib were positive, so Cortes is not surprised to see similar results for dasatinib.

Cortes concedes that there is also a lot of focus on early interventions to optimize the number of patients who achieve the deepest molecular responses, making these patients eligible for treatment discontinuation. Additional studies in the treatment of CML are investigating the addition of ruxolitinib (Jakafi), interferon, and other agents. He notes that the most exciting combination is adding venetoclax (Venclexta); this has showed promising preclinical data, but more data will come in the future.

For more resources and information regarding anticancer targeted therapies in leukemias: http://targetedonc.com/resource-center/hematology

"Salamat Dok" features the story of 45-year-old house husband Vicente Gonzales Jr. who was diagnosed with chronic myelogenous leukemia. "Salamat Dok" accompanies Vicente Gonzales Jr. to the Asian Hospital and Medical Center for a free laboratory test, and treats him and his family to a Father's Day celebration.

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